Senior Medical Director Signify Health

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Reporting to the Chief Medical Officer, Health Care Services (HCS), the Senior Medical Director
partners with the CMO to provide leadership of clinical activities that play a pivotal role in
driving clinical excellence and innovation.

Leveraging advanced technologies and data analytics, the Senior Medical Director leads strategic initiatives to optimize outcomes, ensure regulatory compliance, and enhance the overall quality of the in-home evaluation (IHE) and diagnostic and preventative services (DPS). This position combines medical expertise, leadership acumen, client-centric communication and a forward-thinking approach to improve health on a scalable, impactful level.

The Senior Medical Director interacts and engages with internal and external stakeholders,
such as Executive Leadership, Signify network clinicians, Data Analysts and Data Scientists and
Product developers.  They make strategic decisions based on their thorough understanding of
clinical quality management, healthcare industry issues, trends, and the regulatory landscape
and identifies opportunities for improvement and take initiative to improve both new and
existing programs.

What will you do?

Leadership and Team Management:

• Provide strategic leadership including mentoring, coaching, and performance management.

• Collaborate with other functional leaders to ensure alignment and integration of clinical initiatives with overall organization goals

• Foster a culture of continuous learning, innovation, and excellence within the clinical team

Clinical Strategy and Oversight:

• In collaboration with the Chief Medical Officer, develop and execute clinical strategies to improve health outcomes.

• Monitor and evaluate clinical performance metrics and outcomes, making data-driven decisions to drive improvement.

Quality Improvement and Monitoring:

• Develop and implement quality improvement programs and initiatives to enhance member and provider safety, satisfaction and quality.

• Develop and implement quality improvement programs and initiatives to enhance clinician safety and satisfaction in collaboration with other stakeholders.

• Collaborate with stakeholders to identify areas for improvement and drive initiatives to address gaps and optimize processes.

• Clinical Documentation Accuracy (CDA):

• Lead efforts to monitor CDA, adherence to best practices, and Signify clinical guidelines across all clinical programs

• Work closely with data science and business enablement on methodology for reporting.

Regulatory Compliance:

• Ensure compliance with regulatory requirements, credentialing standards, and quality metrics set by regulatory bodies and industry organizations.

• Oversee regulatory and compliance teams to develop and maintain policies, procedures, and documentation related to quality and clinical effectiveness.

Collaboration and Communication:

• Collaborate with internal and external stakeholders to optimize member and provider experience and outcomes.

• Communicate effectively with executive leadership, presenting clinical insights, strategies, and performance reports.

Research and Innovation:

• Stay updated with the latest clinical research, trends, and technologies relevant to diagnostic and preventative services.

• Drive innovation by identifying opportunities for new programs, services, or partnerships that enhance member care and outcomes.

• Support research initiatives aimed at evaluating solution outcomes.

Sales and Account Management Support:

• Collaborate with the sales and business development teams to support client acquisition and retention efforts.

• Ensure provision of clinical expertise and insights during client meetings, presentations, and negotiations.

• Act as a medical advisor and liaison for key client accounts, addressing clinical

Basic Qualifications

• Active and current state medical license without encumbrances

• Board Certi